Bwiti is a spiritual practice
that forest-dwelling tribes of West Africa
have been observing for untold millennia.
At the center of this practice is the iboga root,
a plant indigenous to West Africa
with powerful psychoactive effects,
which can last for days.
Initiates are believed to commune with the dead,
and it is believed to heal many ailments.
Many locals consider this ancient practice witchcraft today,
but Westerners have been increasingly drawn
to Bwiti and the mysterious iboga plant,
to cure a widespread modern affliction.
The opioid crisis may be far worse
than initially thought.
We've interviewed lawmakers on the left and the right.
They all say opioid addiction is a problem.
Many believe that this ancient psychedelic root
is the key to curing addiction.
You know, there is no other compound
that will stop somebody
from physically withdrawing on opiates.
It's the only one.
Now, science is rigorously testing
this hypothesis.
Biotech companies are creating analogues of ibogaine,
the primary component of the plant,
and pushing for FDA approval
to help curb the disastrous effects
of the opioid epidemic.
If successful, this mysterious compound
could have the power to heal millions,
while seriously disrupting
the multi-billion dollar opioid market.
In the US alone, over 81,000 drug overdose deaths
occur between 2019 and 2020.
As more data comes in,
that number is expected to be higher,
and the CDC estimates that overdoses
will exceed a hundred thousand in 2021.
The situation couldn't be more urgent,
and addicts are increasingly turning to iboga
after trying everything else to kick their habits.
Usually, they hear it from word of mouth,
and they have to travel abroad
since the substance remains illegal in the United States.
An underground cottage industry has formed
in all corners of the world where iboga is not regulated.
This is the place people come when, you know,
they've tried everything else.
And fortunately, it's something
that really, really works for them.
Thank you, mother nature, for creating iboga
and giving us a tool to go deep inside of ourselves.
Levi Barker has embraced the Bwiti traditions
and now runs a shamanistic healing center
in Costa Rica called Iboga Wellness.
A former addict himself,
he knows the power of the plant first-hand.
I was kind of the first generation
of the opioid epidemic that came through.
I had a snowboarding accident when I was 19,
got prescribed some Percocet, you know,
started taking them, started liking them,
kept growing from there and went through, you know,
every opioid pill you can imagine.
And eventually, that led to heroin as well.
And so a dear friend of mine mentioned iboga.
I was able to just lay there
and let it come in and cleanse me.
And so, I woke up the next day physically free of drugs.
And so I knew from that point forward
that I wanted to work with it.
So, Levi, tell me, what exactly do we know
about this plant and how it works?
With a lot of psychedelics,
nobody's exactly sure how it works,
but at least here, you keep seeing people come in
and getting healed for a wide variety of issues.
You know it does work
because it changes lives and people report back.
Just as with the original Bwiti,
the detox process last days
and involves a carefully crafted setting
as patients ingest the plant.
People come and get the treatment.
They have some time afterwards
where they get the proper coaching
and then definitely, some after-care involved.
And, you know, it's just a long process
especially when you're dealing with opiate addicts.
I mean, that's at least a three to six-day process for them.
But sending every addict abroad
for a week-long journey to kick their addiction
just isn't practical.
And if it's ever possible to scale this to the level
we would need to make a dent in the epidemic,
we're going to need the help of modern medicine.
My name is Andrew Kruegel.
I am a medicinal chemist and entrepreneur.
Okay, help me understand
the difference between iboga and ibogaine.
Ibogaine is the major active constituent
of the Tabernanthe iboga plant.
So, the plant itself contains
a number of different psychoactive compounds,
and ibogaine as the most well-known of those.
That was first noted by a man
named Howard Lotsof in the 1960s,
who had had a long history of addiction to heroin,
and he visited Western Africa
looking for potential ways to treat his affliction.
And he ended up going through an iboga ceremony
with the native people there,
and found himself cured of his heroin addiction.
He brought that knowledge back to the West
and popularized it.
But just as soon as it was popularized,
it was labeled dangerous with no medical use.
In order to fight and defeat this enemy,
it is necessary to wage a new, all-out offensive.
It got pulled in with all the other psychoactive compounds
into the Schedule I classification at that time,
despite the fact that there's no real history
of abuse of ibogaine for recreational purposes.
In fact, the ibogaine trip is not really
a recreational experience at all.
The drugs legal status
is only one of its hurdles.
There are also some serious safety concerns,
including its high toxicity levels
and a tendency to induce cardiac arrhythmias,
which in rare circumstances, have resulted in death.
Ibogaine blocks a ion channel in the heart
called the hERG channel, and blocking this ion channel
can cause what's called QT prolongation.
So the part of the heart rhythm gets elongated,
and that has led to some deaths
under the sort of uncontrolled circumstances
in which it's used.
We think that ibogaine itself
under a more controlled setting
with proper EKG monitoring,
could be safe enough already to use,
but with our novel analogues,
we're trying to reduce inhibition of that hERG channel,
and thereby attenuate those cardiac risks.
But for many people
desperate to kick their addiction,
they're already willing to take that risk.
In recent years, Levi's clinic has seen
a surge in clients looking for help
with more than just opioid addiction.
We have people come here for over-eating.
Some people have sex or porn addictions.
People get addicted to thinking in the past,
or they grew up with different belief systems
that just filters their whole worldview.
And this is really where science hits
a blind spot, since no large clinical trials
have taken place with ibogaine,
and anecdotes like Levi's are not going to get far
when it comes to FDA approvals.
There's certainly a large amount
of anecdotal data to support its efficacy,
and those small trials and anecdotes
support it being extremely efficacious,
not just in opioid addiction, but also in alcoholism,
psychostimulant addiction, et cetera.
But it's never been tested in a serious trial
with hundreds of patients and appropriate controls.
So, until that's done, we can't say with any certainty
that this is actually going to work.
So there's this study published in December of 2020.
It's a non-toxic ibogaine analogue
that separates the psychoactive effects
from the anti-addictive properties.
It was successfully tested on rodents,
which is a long way from being tested on humans.
Now, do you think there's a need
for the psychoactive element
for this drug to properly work?
Or can we just extract these molecules,
separate them, and take what we need?
I think that's the big question to answer,
not just in ibogaine research,
but in psychedelic research across the board.
Whether the higher level cognitive experience
of a hallucinogenic transformative experience
is what drives the efficacy, or if it's simply
underlying neurobiological changes
that we're not really aware of at the conscious level.
And I think it's possible
that both things are important.
You might be aware of this
transformative psychedelic experience
while you're on the drug, but behind the scenes,
there may also be a resetting of your reward circuitry
and that sets on nerve root factors
in the nucleus accumbens or the ventral tegmental area
that actually physically reset
some of the bad connectivity that has developed
as the result of an addictive history.
But we don't really understand
the neurobiological underpinnings of human consciousness.
Trying to unravel that mystery
is sort of also unraveling the mystery
of what makes us human, right?
That mystery is not scaring away investors,
who not only firmly believe in ibogaine's efficacy,
but aim to cut into the profits that big pharma
has reaped for years off of opioid addiction.
The addiction industry in the US
is a $42 billion market.
And that market is expected to grow
to about 54 billion by 2025.
The growing size of the opioid use disorder market
is what's actually incited a lot of the psychedelic biotechs
to address this gap in the market.
But the substance is very understudied
and it remains a Schedule I drug.
Doesn't that make it kind of a risky bet for you?
There's no doubt that when it comes to the psychedelics
that are currently at the forefront of research,
that ibogaine is amongst the most riskiest ones,
but what's also happened over the last three years
is there has been a phenomenal amount of research done
with new chemical entities
that have de-risked it drastically.
So if it's something that's de-risked in a very big way,
and yet is incredibly efficacious to fight these cravings
and addictive qualities that a lot are suffering from,
I mean, that's immense progress
and that is something that we're going to bet on.
So how do you get this substance de-scheduled
and scaled out to treat the epidemic?
If we can actually show the efficacy rates
with very low toxicity and very little harm,
it will naturally get through the required clinical stages.
And once it gets through those clinical stages,
there's no doubt in our minds.
At least I strongly believe
that the DEA will ultimately have
to take it off the Schedule I abuse list.
Are you at all concerned about losing
the Bwiti's original shamanistic intent of this plant
with that sort of modern medical approach?
You know, we have a lot to be thankful for
to a lot of the indigenous communities around the world
that have shown us these medicines, right,
ibogaine in particular, but you know,
what was revered once as something that was truly magical
is yet coming to the forefront, you know,
with all the research that's going on, and you know,
as Arthur C. Clarke himself put it,
"Magic is just science that we don't understand yet."